Align ChoicePlus (PPO)

Align ChoicePlus (PPO) is a PPO plan offered by Sanford Health available for enrollment in 2025 to people living in South Dakota. This plan received an overall rating of 3.5 out of 5 stars in 2026.

It's important to know that Align ChoicePlus (PPO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.

Key Plan Facts

Below are a few key facts and commonly-asked questions about Align ChoicePlus (PPO).

Plan Costs:

The cost of a Medicare Advantage Plan is made up of four main parts.

• First, the monthly premium — the amount you pay every month.
• Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
• Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
• Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.

You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.

Common Services:

Drug Coverage

The Align ChoicePlus (PPO) Medicare plan features an annual drug deductible of $350. Under this plan, you will pay no copay for Tier 1 preferred generic drugs at preferred pharmacies and preferred mail order, and no copay for Tier 6 select care drugs at any pharmacy. Tier 2 generic drugs are also highly affordable, starting at a $4 copay for a one-month supply at preferred pharmacies. For Tier 3 preferred brand drugs, copays start at $42 for a one-month supply at preferred pharmacies and mail-order services. Higher-tier medications require coinsurance rather than a copay, with a 48% coinsurance for Tier 4 non-preferred drugs and a 29% coinsurance for Tier 5 specialty drugs. Choosing preferred pharmacies or preferred mail order will consistently provide the lowest out-of-pocket costs for your prescriptions.

Additional Benefits

The Align ChoicePlus (PPO) plan offers comprehensive medical coverage with no copay and no coinsurance for primary care visits, telehealth, and routine preventive care. For specialist visits, copays range from no copay up to $50 with no coinsurance, while inpatient hospital stays require a $300 daily copay for the first five days and no copay for days six through ninety. Emergency room visits carry a $120 copay, which is waived if you are admitted within three days, and urgent care services require a $45 copay with no coinsurance. This plan also includes valuable supplemental benefits, including preventive dental coverage with no copay or coinsurance up to a $750 annual limit, and routine hearing exams with no copay alongside a $700 annual hearing aid allowance. Vision care is partially covered, offering annual routine eye exams with no copay and 20% coinsurance, plus a $100 annual limit for eyewear. Additionally, members benefit from a $70 quarterly over-the-counter reimbursement with no copay and no coinsurance, while durable medical equipment is covered with no copay and a 20% coinsurance.